Real and Perceived Discordance in Physicians and U.S. Adults' Beliefs Regarding the Causes and Controllability of Type 2 Diabetes

Discordance between physicians and patients' health beliefs can impede health communication efforts. However, little research considers physicians' perceptions of patient beliefs, despite the importance of perceptions in shaping communication. In the current work, we examine instances of actual and perceived discordance between physicians and U.S. adults' beliefs regarding the causes and controllability of type 2 diabetes. 229 family physicians completed an online survey measuring their health beliefs and perceptions of their patients' beliefs. Physicians' responses were contrasted against beliefs from a national survey sample of 1,168 U.S. adults. T-tests assessed whether (a) physicians' beliefs diverged from the national sample's beliefs (actual discordance), (b) physicians perceived that their health beliefs diverged from their patients' beliefs (perceived discordance), and (c) physicians' perceptions of patient beliefs diverged from the national sample's beliefs (accuracy of perceived discordance). Findings revealed evidence of actual discordance; compared to the national sample, physicians were more likely to attribute type 2 diabetes to genes (versus lifestyle factors) and perceived greater control over developing diabetes. Moreover, although physicians perceived discordance between their own and their patients' beliefs, data from the national sample suggested that these gaps were less substantial than physicians expected. In particular, findings showed that physicians generally overestimated discordance, expecting that people would be less likely to (1) attribute the development of diabetes to lifestyle factors (versus genes), and (2) perceive control over developing diabetes, than was actually reported. Implications of actual and perceived discordance for effective health communication and patient education are discussed.

Children's beliefs about causes of human characteristics: Genes, environment, or choice?

To what extent do our genes make us nice, smart, or athletic? The explanatory frameworks we employ have broad consequences for how we evaluate and interact with others. Yet to date, little is known regarding when and how young children appeal to genetic explanations to understand human difference. The current study examined children's (aged 7-13 years) and adults' explanations for a set of human characteristics, contrasting genetic attributions with environmental and choice-based attributions. Whereas most adults and older children offered an unprompted genetic explanation at least once on an open-ended task, such explanations were not seen from younger children. However, even younger children, once trained on the mechanism of genes, endorsed genetic explanations for a range of characteristics-often in combination with environment and choice. Moreover, only adults favored genetic explanations for intelligence and athleticism; children, in contrast, favored environment and choice explanations for these characteristics. These findings suggest that children can employ genetic explanations in principled ways as early as 7 years of age but also that such explanations are used to account for a wider range of features by adults. Our study provides some of the first evidence regarding the ways in which genetic attributions emerge and change starting in early childhood. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Understandings of basic genetics in the United States: results from a national survey of black and white men and women

AIM

This study examined understandings of basic genetic concepts among Americans.

METHOD

In a national telephone survey of 1,200 Americans with equal representation among Black and White men and women, subjects responded to 8 items developed by a multidisciplinary team of experts that assessed understanding of basic concepts in multiple domains, including inheritance, genetics and race, and genetics and behavior.

RESULTS

Over 70% of subjects responded correctly on items about the genetic similarity of identical twins and siblings. Less than half of subjects responded correctly on all other items. Understanding of genetics was lowest in three areas: types/locations of genes in the body (29% correct), a genetic basis for race (25% correct), and the influence of single genes on behaviors (24% correct). Logistic regression models controlling for age and education showed some differences by race and gender on specific items but also showed that understandings are generally similar across these groups.

CONCLUSION

Misunderstandings about genetics are common among Black and White American men and women. Responses appear to reflect personal experiences, group values and interests. These findings emphasize the need for initiatives to improve the public's genetic literacy as well as a need for further investigation in this domain.

Unemployment and work interruption among African American single mothers: effects on parenting and adolescent socioemotional functioning

Using interview data from a sample of 241 single African American mothers and their seventh- and eighth-grade children, this study tests a model of how 2 economic stressors, maternal unemployment and work interruption, influence adolescent socioemotional functioning. In general, these economic stressors affected adolescent socioemotional functioning indirectly, rather than directly, through their impact on mothers' psychological functioning and, in turn, parenting behavior and mother-child relations. Current unemployment, but not past work interruption, had a direct effect on depressive symptomatology in mothers. As expected, depressive symptomatology in mothers predicted more frequent maternal punishment of adolescents, and this relation was fully mediated by mothers' negative perceptions of the maternal role. More frequent maternal punishment was associated with increased cognitive distress and depressive symptoms in adolescents, and consistent with predictions, these relations were partially mediated by adolescents' perceptions of the quality of relations with their mothers. Increased availability of instrumental support, as perceived by mothers, predicted fewer depressive symptoms in mothers, less punishment of adolescents, and less negativity about the maternal role. Both economic stressors were associated with higher levels of perceived financial strain in mothers, which in turn predicted adolescents' perceptions of economic hardship. Adolescents who perceived their families as experiencing more severe economic hardship reported higher anxiety, more cognitive distress, and lower self-esteem.